Acne Vulgaris and Metabolic Syndrome: A Possible Association

Epidemiology and Healthcare of Juvenile and Late-Onset Acne: Claims Data Analysis

INTRODUCTION

Acne is the most frequent chronic inflammatory skin condition in adolescence but occurs also in later age. Our study aimed to characterise the epidemiology, geographical distribution, comorbidity and healthcare of acne juvenilis (AJ) and acne tarda (AT).

METHODS

Statutory health insurance (SHI) data from 2016 to 2020 were analysed. Prevalence rates, including geographical distribution, comorbidities and drug use by specialists group, were measured.

RESULTS

In 2020, the prevalence of acne among adults was 1.50% (AT > 25 years) and among adolescents was 3.88% (AT ≤ 25 years). The highest prevalence (13.02%) was observed at the age of 17 years. Sex differences were higher in AT (73.80% in women) than in AJ (64.55% in women). Compared with non-affected persons, individuals with acne - in particular with AT - showed significantly higher rates of skin-related comorbidities, including folliculitis (rate ratio (RR) 8.89), pyoderma (RR 7.27) and rosacea (RR 5.53), and non-skin-related comorbidities, such as ovarian dysfunction (RR 2.36), rhinitis allergica (RR 1.84) and Crohn's disease (RR 1.79). Preferred systemic therapeutics prescribed were anti-infectives in AT (46.86%) and retinoids in AJ (52.35%). In the majority of cases, dermatologists were involved in the treatment of acne (AT 65.77%; AJ 76.27%). The most commonly prescribed topical agents were adapalene with benzoyl peroxide (AT 87.72%; AJ 85.75%), while systemic isotretinoin (AT 81.20%; AJ 90.06%) was also a frequently used drug. General practitioners were more likely to prescribe anti-infectives, especially topical antibiotics such as chlortetracycline (AT 52.38%; AJ 44.44%) and systemic antibiotics, especially tetracycline (AT 58.33%; AJ 67.50%).

CONCLUSION

Acne affects a relevant proportion of the German population not only in adolescence, and management of this inflammatory skin disease does not naturally follow medical guidelines or specialist recommendations. These findings emphasise the importance of specialised care and comprehensive therapeutic management that should also consider the exploration of comorbidities.

Do patients with acne tend to have increased body fat? Comparison of body composition analysis of patients with acne vulgaris and healthy individuals: a prospective case control study

BACKGROUND

Acne vulgaris is a chronic, inflammatory skin disease which has been associated with metabolic syndrome and obesity. However, data on body composition in patients with acne vulgaris are scarce.

AIM

We aimed to assess body composition in patients with acne vulgaris, compare the results with those of healthy individuals, and evaluate the relationship between body composition and acne severity.

METHODS

Between March 2023 and May 2023, body composition of patients with acne vulgaris and healthy individuals was prospectively evaluated using Tanita TBF-300 body composition analyzer.

RESULTS

This study included a total of 320 subjects, 160 patients with acne vulgaris and 160 healthy individuals. Body mass index (BMI), body fat percentage and fat mass were significantly higher in patients with acne vulgaris compared to healthy individuals (p < 0.001, each). BMI, body fat percentage and fat mass were significantly higher in female patients compared to healthy females (p < 0.001, each), higher in male patients compared to healthy males (p = 0.001, p < 0.001, p < 0.001, respectively). BMI (p = 0.006), fat free body mass (p < 0.001) and total body water (p < 0.001) were higher in male patients, while body fat percentage (p < 0.001) was higher in female patients. Patients with moderate to severe acne had higher BMI (p < 0.001), body fat percentage (p = 0.001) and fat mass (p < 0.001) than in those with mild acne.

CONCLUSION

Since high body fat may indicate increased risk and severity of acne, body composition analysis may be useful in treating patients with acne and taking preventive measures against metabolic syndrome in this population.

Selected hormone levels and lipid abnormalities in patients with acne vulgaris

Introduction

Acne vulgaris is one of the most common dermatological diseases. Hormonal imbalance affects the skin condition and results in the formation of acne vulgaris lesions.

Aim

To evaluate serum levels of testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), triglycerides (TG), and high-density lipoprotein (HDL) in patients with acne vulgaris and compare them to healthy population.

Material and methods

Forty-one patients with acne vulgaris and 47 age- and body mass index (BMI)-matched controls were enrolled in the study.

Results

The mean ± SD testosterone serum level in the study group was 0.45 ±1.03 ng/ml in females and 4.24 ±0.68 in males and in the control group 0.73 ±2.03 ng/ml and 5.3 ±1.3 ng/ml in females and males, respectively. The prolactin serum level was 16.73 ±8.02 ng/ml in the study group and in the control group 13.74 ±8.71 ng/ml (p = 0.011). The FSH serum level was 12.17 ±16.93 mIU/ml and 6.2 ±7.3 mIU/ml in the study and control groups, respectively (p = 0.0001), whereas LH serum levels were 18.44 ±19.71 mIU/ml and 11.26 ±8 mIU/ml, respectively (p = 0.2659). The HDL serum level was 65.63 ±15.67 mg/dl in the study group and 61.53 ±15.89 mg/dl in the control group (p = 0.219), and TG levels were 175.29 ±82.15 mg/dl and 87.32 ±30.64 mg/dl, respectively (p < 0.00001).

Conclusions

Our study demonstrates, that hormonal and lipid imbalance could be linked to acne vulgaris formation. Evaluation of hormonal and lipid abnormalities could help in treatment decisions and could affect the occurrence of complications and the course of acne.